Infecção latente pelo Mycobacterium tuberculosis em trabalhadores da saúde

Abstract

The study analyzed the prevalence of latent Mycobacterium tuberculosis infection among healthcare workers at a federal university hospital in Rio de Janeiro. This was a cross-sectional epidemiological study conducted with 228 professionals, using a sociodemographic, occupational, health, and exposure questionnaire, as well as records of the tuberculin skin test. Data were processed using the Statistical Package for the Social Sciences, version 21.0, and analyzed through bivariate tests using odds ratios (OR) with 95% confidence intervals (95% CI). Pearson’s chi-square test and Fisher’s exact test, when appropriate, were applied, adopting a significance level of p < 0.05. Higher odds of LTBI were observed among female workers (OR = 1.96; 95% CI = 0.8–4.5), non-white individuals (OR = 1.44; 95% CI = 0.8–2.5), older age groups (OR = 1.36; 95% CI = 0.7–2.3), those with longer professional experience in healthcare (OR = 1.15; 95% CI = 0.6–2.0), multiple employment links (OR = 1.45; 95% CI = 0.8–2.5), and workloads exceeding 40 hours per week (OR = 1.17; 95% CI = 0.6–2.0). The nursing category presented significantly higher odds of infection (OR = 2.28; 95% CI = 1.25– 4.1; p = 0.007). Increased odds were also observed among workers with BCG scars (OR = 2.01; 95% CI = 0.5–7.4), those reporting BCG revaccination (OR = 2.87; 95% CI = 1.5–5.3), and those with diabetes or other comorbidities (OR = 1.47; 95% CI = 0.40–4.70) or using immunosuppressive drugs (OR = 3.84; 95% CI = 0.3–43.0). A trend toward higher risk was identified among individuals with known occupational contact with tuberculosis cases (OR = 1.56; 95% CI = 0.6–3.5). Household contact showed a higher LTBI proportion (60.0% among exposed individuals) but without statistical significance (p = 0.344). Similarly, contact with patients diagnosed with pulmonary tuberculosis in the previous year slightly increased the risk but was not statistically significant (OR = 1.06; 95% CI = 0.6–1.8). Most participants (47.4%) reported inadequate workplace infrastructure, and 87.3% stated that PFF2/N95 masks were available; however, inadequate mask use showed no significant association with LTBI (OR = 1.39; 95% CI = 0.6–3.2) and was considered a confounding factor. Smoking was not associated with LTBI (OR = 0.93; 95% CI = 0.30–2.60). The study enabled the training of nursing technicians in the administration and reading of the tuberculin skin test, as well as in the surveillance of Mycobacterium tuberculosis infection. The findings reaffirm that working conditions are structural and decisive factors for occupational exposure to the pathogen, constituting determinants of latent tuberculosis infection among healthcare workers.